John Silver

Good luck with the petition. Rick Perry has demonstrated over and over again that he is clueless. First, he supported HPV vaccination. Then, he attacks Planned Parenthood. These people are ALL out of control- mostly as a result of their religious views or at least their perception that these loudmouthed christian fanatics are who they have to appease if they want to get elected. It just goes to show why the rest of us have to turn out for elections, every election. When we let these dimwits get in at the state level, bad things happen.

Weel, it's really up to us, no? There are multiple problems you have identified. First, nurse managers do not represent their staff nurses, they work for the administration. CNO's are hired by CEO's, not elected by nurses. They do their master's bidding, and that is overtly demonstrated in staffing ratios, particularly on the "floors". The California experience has shown us, as nurses, that we CAN do something about this. Problem is that it requires SOME effort on our part, and that seems to be the problem in getting anything done. There is NO doubt that patient care suffers under understaffing. A new book out (just a union...of nurses) talks about this very issue and shows how the California bedside care nurses accomplished this feat. No other state has been able to do this because it is opposed by the American Hospital Association which is the 5th most powerful lobbying group in the country (and I must say they are supported by the American Association of Nurse Executives AONE) in their efforts. This political "fracture" in nursing has been going on since 1903, and it has subjugated nursing and nurses to "others". Is it time we changed this- YES Can we change this- YES Can we do it as individual nurses- NO Is there a nursing organization which is trying to do something about all this- YES You don't have to be unionized to support the NNU efforts. You can join and support them for $60 a year, as I have. They have a proven track record of political success for patient safety/realistic ratios. Unfortunately, for all of us, the vast majority of nurses will do nothing.

Well, that is where the U.S. Constitution breaks away- It clearly states (based on the Declaration of Independence) that the right to life, liberty, and the pursuit of happiness are NOT rights granted by a government, but are human rights inherent to us due to our creation, however that may have been done. The Constituionally guaranteed rights are spelled out in the Bill of Rights, but were designed to be "generic" in recognition that they could not possible predict how life would change in subsequent generations. There is no "right" to drive a car, to have electricity provided to your house, to have access to food, to vote, to have access to healthcare, or even to get married and have children. Each generation has had to make decisions about what "rights" mean, and how they change over time. The government has a Constitutional obligation to "provide for the general welfare".

Maybe it's my imagination, but it seems like the more evangelical christian groups there are in a state, the more assinine the state policies are.

How??? How can we prevent obesity?

I meant good luck in the best way. You're right, and as I said before, I don't know what state you are in. Good luck! Unity will depend on who is doing the unification and what their goals are. With ANA membership at less than 5% and most ANA related state associations in the same boat, it just becomes a matter of financial reality. Political effectiveness does not happen very often do to noble intentions. Being "engaged" in the political process is not the same thing as being politically effective. Glad to hear you are pro-union. Personally, I think the state solution is the easiest, and only 1 group has managed that..

There are some surveys available_ The ANA surveyed 76,000 nurses in 2004 and you can find those results. There have been other surveys, but it's difficult when you survey nationally because you don't know what position nurses have and that can greatly influence the responses. This is one of the biggest problems we have as academics (at least for those of us who care about such things), nursing surveys are generally proprietary to the group that surveyed them, and most facilities don't want the survey data coming out for obvious reasons. While Magnet facilities SHOULD be releasing this data, thay too are very proprietary and were analysing the data themselves. Not sure if that has changed or not. Facilities, in general, do not want researchers coming in and surveying their nurses.

In response to the 4 patient assignments in ICU- Unbelievable! Why do we put up with this???????

Good luck with that! We are all striving for the same goals as bedside nurses- fair ratios so we can do actual nursing, not just medical task completion. I have read just abiout every book regarding politics in nursing, and believe me, I've also been actively engaged in the political process. I know what goes on behind closed doors. I've been a nurse for almost 30 years, and in healthcare for 40 years. I've also done internships in D.C. and in my state. Your state asociation, with only a few exceptions, is an ANA affiliate. I don't want to argue, but your understanding of the political process is naive if you think these things are just going to happen. However, I don't know what state you practice in, that is correct. Maine, Minnesota, and Massachusetts are moving forward. New York also has an active state association. In spite of this, California is the ONLY state to have enacted practice protection for nurses in terms of ratios. We have to change that. Again, good luck!

It is unfortunate that each state has its own challenges, but it does take some great grass roots organization and coming together to collaborate for the safety of our patients. Yes, it does take grass roots organization. That is what this book really talks about. How to do this. We are nurses and are not necessarily educated in how to achieve political victories. The model examined in this book presents a way to organize and become politically effective. Not sure what state you are in, but good luck with the ratios. I would also argue that our political "foes" are very strong and politically well connected. That requires a special effort in achieving political results. Opposing the AHA and/or the AMA is daunting. SO, it is not really a level playing field and it requires special tactics to get success. So in that sense, powerlessness is not necessairly an internal thing so much as it's a structural thing. I do not feel powerless as a person, but we are politially powerless in many cases as nurses.

The floors at Delray (Deathray, Hellray) are poorly run, poorly managed and poorly staffed. Of course, it's a TENET hospital so not much of a surprise really. Good luck, and as a previous poster commented, if you can survive Delray with your license intact, you can work anywhere.

The commuter: What a shame that so many RN's feel the same way about acute care. The bigger question is, in my mind, what are we going to do about it????

Unfortunately, the ANA knows very little about safe staffing. They have been relying on their 1993 "Safe Staffing Initiative" for almost 20 years now. Nursing surveys show little improvement and staffing ratios continue to be a major source of discontent for nurses, particularly on the tele and med sure floors. Relying on nursing administrators to set a safe staffing level is ridiculous. They are told what the staffing level will be by CEO's, not using any kind of genuine acuity system (since there really isn't any reliable acuity system), and have little if any direct control. If they did, we could hold them responsible for any issues legally. Mandated ratios are the only thing the "industry" will listen to, as California has demonstrated. I encourage EVERY nurse and nursing student to critically look at nursing organizations and support those that support the bedside practice of nursing, since that is our core. So far, only the NNU has done anything.

Good, quit